Provider Demographics
NPI:1326569617
Name:LOGAN CIRCLE HEALTH SUPPLIES
Entity Type:Organization
Organization Name:LOGAN CIRCLE HEALTH SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:WAQAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-798-5919
Mailing Address - Street 1:331 GEORGE KOSTAS DR STE 302
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:WV
Mailing Address - Zip Code:25601-3493
Mailing Address - Country:US
Mailing Address - Phone:202-798-5919
Mailing Address - Fax:
Practice Address - Street 1:331 GEORGE KOSTAS DR STE 302
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:WV
Practice Address - Zip Code:25601-3493
Practice Address - Country:US
Practice Address - Phone:202-798-5919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies